Individual provider Active NPI

Brian Gradinger, D.M.D.

  • Dentist
  • Valencia, CA
National Provider Identifier
1265846190
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
63488 Issued in CA
Practice address
27335 Tourney Rd Ste 250
Valencia, CA 91355-2206
Phone
(661) 287-9650
NPI assigned
Jun 18, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 63488 CA Primary

Addresses

Primary practice location

27335 Tourney Rd Ste 250
Valencia, CA 91355-2206

Mailing address

27335 Tourney Rd Ste 250
Valencia, CA 91355-2206
Phone (661) 287-9650

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160727001962 CA Order and Referring Only - DentistPractitioner - Dentist 5698068716

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1403049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1265846190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27335 TOURNEY RD STE 250",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913552206",
            "telephone_number": "661-287-9650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27335 TOURNEY RD STE 250",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913552206",
            "telephone_number": "661-287-9650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRADINGER",
        "first_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-18",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "63488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valencia, CA

Sources for this page

Verify at the official NPI Registry.